Proposed Tricare fee hikes dead for now

Apr. 30, 2014 - 06:28PM
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Hospitalman Henry Molina, a corpsman with Naval Hospital Pensacola, checks the blood pressure of Karen Kearney during her appointment with Family Medicine. Making appointments is just one of the options TRICARE Online provides to TRICARE beneficiaries to make receiving medical services even easier. Photo by MC1 James Stenberg (Courtesy Photo / U.S. Navy)

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A House subcommittee has rejected a Pentagon plan to consolidate Tricare Prime, Standard and Extra into a single system that would have resulted in higher heath care fees for nearly all Tricare beneficiaries.

But the debate over the future of the military’s health program is far from over.

The House Armed Services Committee’s personnel panel, chaired by Rep. Joe Wilson, R-S.C., unanimously approved on Wednesday the personnel portions of the committee’s version of the 2015 defense authorization bill, protecting military family members and retirees from health care fee increases.

Wilson said subcommittee members believe any changes to Tricare should wait until after the Military Compensation and Retirement Modernization Commission releases its recommendations on pay and benefits early next year.

“We need to be informed [of the commission’s] analysis before proceeding with wide-impacting changes,” Wilson said.

The Defense Department fiscal 2015 budget proposed to roll the three major Tricare programs into a single entity starting in January 2016. The plan would have introduced fees for retirees at military hospitals and clinics, add enrollment fees for Tricare for future retirees when they became eligible for Tricare For Life and Medicare, and increase prescription drug co-pays at retail stores and by mail order.

Pentagon officials said the changes were needed to rein in the burgeoning health care budget, which tops more than $50 billion a year.

But instead of increasing any fees, the House subcommittee called on the Pentagon to submit several reports on its health programs and systems, including an assessment of Tricare Standard and Extra with information on whether enough health care providers accept Tricare, a report on the reduction of Tricare Prime service areas and a study of the Defense Health Agency’s ongoing consolidation efforts.

As written, the bill also includes provisions requiring the military services to provide one-on-one mental health screenings for troops for every 180 days they are deployed. It also would require DoD to advise personnel of their privacy rights regarding mental health services and records as early as boot camp or initial officer training.

Should the Tricare restrictions remain in the final bill, most beneficiaries will see only nominal increases in fees in 2015. By law, Tricare Prime enrollment fees for retirees and families would increase by 1.5 percent — the amount of the 2014 cost-of-living adjustment increase.

Retirees on Prime would pay an annual enrollment fee of $277.95, up from $273.84, while families would pay $555.90, up from $547.58.

The House subcommittee action is only the first step in the lengthy legislative process on the defense bill. The full armed services committee, and then the full House, must approve the bill.

The Senate independently works on its own version of the bill in similar fashion, and the two versions must be reconciled in a conference before a final version is approved and sent to the White House for the president’s signature.

The Senate has not yet unveiled its version of the fiscal 2015 defense bill. But earlier this year, several key senators, including Sen. Kirsten Gillibrand, D-N.Y., chairwoman of the Senate Armed Services Committee’s personnel panel, and Sen. Lindsay Graham, R-S.C., noted the compensation commission’s report in addressing the Obama administration’s budget.

“I am extremely concerned about the cumulative effect on all of these cuts, especially on the junior members of the force and their families,” Gillibrand said at a March 26 hearing. “These benefits proposals are being made while the Military Compensation and Retirement Modernization Commission ... has yet to finish its work.”